Special enrollment on your birthday
On your birthday, you can change Medi Gap plans, guaranteed issue!
If you can’t pass underwriting one would still be able to use the
Birthday Rule GI Guaranteed Issue right for plan A, F, G or N.
The application may be submitted 90 days in advance, for Blue Cross, but the effective date would be for the month after the clients birthday unless their birth date was on the 1st. CA Health Care Advocates * excerpt of email from BC 6.2.2020
- nor discriminate in the pricing of coverage, because of health status,
- claims experience,
- receipt of health care, or
- medical condition of the individual
Blue Shield – Birthday Rule
Excerpt of CA Law
No need to fill out Health Questions
When you fill out the transfer application under the birthday rule, whether ONLINE or Paper, check off the equal or lesser plan that you want.
Then put down the rule – situation # for the Insurance Company that you are using.
When you get to the Statement of Health, you don’t have to fill out any questions.
While these pictures are from the Blue Shield application, the general principles apply to all Insurance Companies.
This is just a summary of the most common ways you can get a Medi Gap plan without having to answer health questions.
- Enrolled in Medicare and are age 65 or older; or New to Medicare, are age 64 or younger, and do not have end-stage renal disease
- You enrolled with A Medicare Advantage Plan and the plan is being terminated;
- terminated from any employer-sponsored health plan,
- moved outside the plan’s service area.
- disenrolled from the plan or program within twelve (12) months of the effective date of that enrollment.
- You terminated enrollment in a Medicare Supplement plan and subsequently enrolled, for the first time, in any of the following:
• A Medicare Advantage Plan;
- MAPD Trial Privileges #02110 Medi-Gap Guide
- The company substantially violated a material provision of the contract; or
- The company or its agent materially misrepresented a provision of the plan in marketing the contract to you.
- You enrolled in a Blue Shield Medicare Advantage Plan, and Blue Shield either:
Reduced any of its benefits;
Increased the amount of cost-sharing or premium;
- You are no longer eligible for Medi-Cal benefits.
- Birthday Rule
Get more detail at:
- Birthday Rule
- Loss of Employer Coverage
- MAPD Trial Period – Come back to Medicare and Medi-Gap
- Medical Questions – Underwriting – If not in Guaranteed Issue Period?
- Medicare Advantage Reduces Benefits, Co Pays, increase in premium
- Turn Age 65
On some pages you can Scroll down for our cut & paste of the ACTUAL CA Law